Indiana University-Purdue University Indianapolis (IUPUI) / Background. Despite widespread criticism of physician-performed evaluations of medical students’ clinical skills, clinical clerkship evaluations (CCEs) remain the foremost means by which to assess trainees’ clinical prowess. Efforts undertaken to improve the quality of feedback students receive have ostensibly led to higher assessment demands on physician faculty; the consequences of which remain unknown. Accordingly, this study investigated the extent to which physicians’ evaluative responsibilities influenced the quality of CCEs and qualitatively explored physicians’ perceptions of these evaluations. Methods. A questionnaire was delivered to physicians (n = 93) at Indiana University School of Medicine to gauge their perceived evaluative responsibilities. Evaluation records of each participant were obtained and were used to calculate one’s measurable quantity of CCEs, the timeliness of CCE submissions, and the quality of the Likert-scale and written feedback data included in each evaluation. A path analysis estimated the extent to which one’s evaluative responsibilities affected the timeliness of CCE submissions and CCE quality. Semi-structured interviews with a subset of participants (n = 8) gathered perceptions of the evaluations and the evaluative process. Results. One’s measurable quantity of evaluations did not influence one’s perceptions of the evaluative task, but did directly influence the quality of the Likert-scale items. Moreover, one’s perceptions of the evaluative task directly influenced the timeliness of CCE submissions and indirectly influenced the quality of the closed-ended CCE items. Tardiness in the submission of CCEs had a positive effect on the amount of score differentiation among the Likert-scale data. Neither evaluative responsibilities nor the timeliness of CCE submissions influenced the quality of written feedback. Qualitative analysis revealed mixed opinions on the utility of CCEs and highlighted the temporal burden and practical limitations of completing CCEs. Conclusions. These findings suggest physicians’ perceptions of CCEs are independent of their assigned evaluative quantity, yet influence both the timeliness of evaluation submissions and evaluative quality. Further elucidation of the mechanisms underlying the positive influence of evaluation quantity and timely CCE submissions on CCE quality are needed to fully rationalize these findings and improve the evaluative process. Continued research is needed to pinpoint which factors influence the quality of written feedback.

IntroductionOver the last decades a positive shift in attitudes towards legalisation of assisted dying (AD) (AD including euthanasia (EUT) and physician-assisted suicide (PAS)) have occurred in western Europe. Physicians are generally more negative than the general public toward legalisation. Medical students’ attitudes, as future practitioners, are important to assess when addressing this ethically complex issue.AimThe aim was to explore the attitudes among medical students at Örebro university, Sweden regarding assisted dying and their stance on the legalisation of assisted dying and to evaluate if religious beliefs, current term of study, gender, and a shift of legal framing would affect medical students´ attitudes.MethodsA cross-sectional online-based anonymous survey containing eight different patient scenarios was distributed to all medical students enlisted at Örebro university Sweden (n=657). Association between demographics and positive attitudes towards AD was tested using logistic regression, and McNemar for difference of proportion in attitudes between various scenario framings.ResultsThirty five percent (n=229) of the medical students responded with completed questionnaires. Sixty percent of the respondents believed PAS for terminally ill patients should be legalized in Sweden. Shifting of legal framing resulted in statistically significant differences of position in all eight scenarios (p<0.05). Strong religious beliefs were associated with decreased likelihood for positive attitudes towards AD in scenario 1-6 (p<0.05).ConclusionsMost respondents in this study believed PAS should be legalised. Held attitudes toward AD were affected by religious beliefs and legal framework. Additional studies to further explore medical students´ attitudes are deemed necessary.

No description available.

Student motivation in medical education courses is essential for the development of life-long medical knowledge. Researchers have demonstrated that student learning in anatomy courses, fundamental to students' future medical learning, has suboptimal long-term outcomes. The purpose of this study was to investigate how medical students' motivation-related perceptions and course effort were different during the academic year through varied course content and elements of instruction. The study was guided by the MUSIC Model of Motivation theoretical framework and nested in the pragmatic paradigm. First-year medical students enrolled at a small, public allopathic medical school in the southeastern United States were surveyed and interviewed regarding their course perceptions. Quantitative data from 18 students and qualitative data from 14 students indicated that students' motivation-related perceptions and effort do vary over different course content and elements of instruction. Students consistently reported lower motivation-related perceptions and effort for prerecorded lectures, whereas they reported more positive motivation-related perceptions and effort for cadaver dissection. Results also indicated variability in motivation-related perceptions and effort among specific block content areas (e.g., musculoskeletal, cardiovascular, abdominopelvic). Study findings resulted in a variety of suggestions for course instructors on how anatomy course design and instructional practices could be intentionally adjusted in the interest of fostering student motivation and engagement. Implications for course design and instruction included general course guidance (e.g., clinical relevance, clear and broad understanding of course usefulness), prerecorded lecture recommendations (e.g., catalogued for easy reference, short and focused, effective use of visual and verbal elements), and cadaver lab instruction guidance (e.g., faculty and upper-level student engagement, student preparation expectations). / Doctor of Philosophy / The purpose of this study was to investigate how medical students' motivation-related perceptions and course effort were different during the academic year through varied course content and elements of instruction. The study was guided by the MUSIC Model of Motivation which is a resource course instructors can use to develop their courses in ways that support students' motivation and engagement. The MUSIC Model is an acronym (i.e., eMpowerment, Usefulness, Success, Interest, and Caring) and each letter represents one of five categories of strategies that teachers can use to motivate students. Instructors who use strategies in these categories can improve student motivation which can help encourage students to engage in their learning. First-year medical students enrolled in an anatomy course at a small, public medical school in the southeastern United States were surveyed and interviewed regarding their perceptions of the anatomy course. Information gathered from this study indicated that students' motivation and engagement vary over different course content and elements of instruction. Students consistently reported lower motivation-related perceptions and effort for prerecorded lectures. Students reported more positive motivation-related perceptions and effort for cadaver dissection. Results also indicated unevenness in motivation-related perceptions and effort among specific block content areas (e.g., musculoskeletal, cardiovascular, abdominopelvic). This study offered a variety of suggestions for course instructors on how anatomy course design and instructional practices could be intentionally adjusted in the interest of fostering student motivation and engagement.

INTRODUÇÃO: Existe uma atenção crescente pela introdução de disciplinas de ciências humanas e de artes na educação médica. A música é instrumento pouco utilizado no ensino médico. Ela possui características únicas que a tornam um excelente recurso educacional, pela possibilidade de exprimir emoções. Em poucos minutos, temas de interesse no aprendizado médico, como a perda, a compaixão, a tristeza e a solidariedade, podem ser identificados e utilizados em processos pedagógicos. A música como outras manifestações artísticas permite lidar com o universo afetivo do aluno. Promover a atitude reflexiva dentro de uma disciplina acadêmica requer criar espaço formal para fazê-lo. OBJETIVO: Apreender o impacto da música como recurso pedagógico na experiência do estudante de medicina. METODOLOGIA: A pesquisa segue uma abordagem de natureza qualitativa. Utilizaram-se músicas pré-definidas pelo autor durante as aulas do módulo em Medicina de Família no internato médico de Faculdade de Medicina do Estado de São Paulo. Participaram doze estudantes que cursaram essa disciplina. As entrevistas foram gravadas, transcritas e, em seguida, xii interpretadas segundo a perspectiva hermenêutica. RESULTADOS: O processo de compreensão da experiência dos estudantes possibilitou o desvelamento de um fenômeno que engloba o seu mundo interno enquanto se ocupa com sua formação médica. A música que toca do lado de fora ressoa na história e nas emoções do estudante. O aluno percebe que o ritmo imposto pelo curso médico não lhe permite pensar, refletir, seja em sua própria vida, seja em sua formação. A experiência com a música permite ao estudante ouvir seus próprios sentimentos e compartilhá-los com o professor e com seus colegas. Ele se surpreende com lembranças e sentimentos que vêm à tona e que desconhecia ou dos quais não se lembrava. Esses sentimentos estão apresentados em temas que organizam a experiência afetiva do estudante, mobilizada pela música. Surgiram assim diversas categorias temáticas, como a busca de si, família, morte, dúvidas vocacionais e relacionamento com colegas, professores e pacientes CONCLUSÃO: Os resultados encontrados na experiência com a música se apresentam em amplo espectro, oferecendo inúmeras perspectivas de desdobramento no âmbito da educação médica, conforme observamos nos temas surgidos. Como a experiência básica que se tem do mundo é emocional, a música essa forma de conhecimento humano de tonalidade afetiva adquire também força educacional, pois o processo de ensinar não se limita à transmissão de conteúdos; mais que isso, implica, por parte do docente, processos de desenvolvimento de sentidos e de significados para permitir que o xiii estudante reflita e transforme a prática cotidiana, sobretudo na medicina, onde o relacionamento interpessoal é a base para a plena efetividade da futura ação profissional / INTRODUCTION: There is a growing focus by the introduction of courses in humanities and arts in medical education. Music is not widely used tool in medical education. It has unique features that make it an excellent educational resource for the possibility to express emotions. Within minutes, topics of interest in learning medicine as loss, compassion, sorrow, solidarity can be identified and used in pedagogical processes. Music like other forms of art can deal with the emotional universe of the student. Promoting reflective attitude within an academic discipline requires creating space to make it formal. OBJECTIVE: To grasp the impact of music as an educational resource on the experience of medical students. METHODOLOGY: The research follows a qualitative approach. We played songs predefined by the author during the classes in family medicine module at the boarding school of medicine in the state of Sao Paulo. Twelve students who attended this course agreed to participate. The interviews were taped, transcribed and then interpreted according to the hermeneutic perspective. RESULTS: The process of understanding the experience of students allowed for the xv unveiling of a phenomenon that encompasses your inner world as he attends to his medical training. The music played on the outside resonates in the story and emotions of the student. The student realizes that the pace imposed by the medical school does not allow to think about, reflect, whether on his own life, whether in his formation. The music experience allows students to hear their feelings and share them with the professor and peers. He is surprised by memories and feelings that surface and was unaware or they could not remember. These feelings are presented in themes that organize the affective experience of the student, mobilized by the music. Several themes emerged as well as the search for self, family, death, vocational doubts, relationships with peers, professors and patients CONCLUSION: The findings of the experience of the music spectrum come in, offering numerous prospects for development in the context medical education, as noted in the themes that emerged. As the basic experience we have of the world is emotional, the music, this form of human knowledge of affective tone also becomes educational force, because the process of teaching is not limited to transmission of content but, more importantly, implies that the teacher in development processes of meaning and significance to enable the learner, reflect and transform the everyday practice, especially in medicine where the interpersonal relationship is the basis for the full realization of future professional action

Submitted by admin tede (tede@pucgoias.edu.br) on 2017-10-18T12:26:10Z No. of bitstreams: 1 Juliane Macedo.pdf: 937659 bytes, checksum: 6bd1efedb88cd906363654bb887c7ade (MD5) / Made available in DSpace on 2017-10-18T12:26:10Z (GMT). No. of bitstreams: 1 Juliane Macedo.pdf: 937659 bytes, checksum: 6bd1efedb88cd906363654bb887c7ade (MD5) Previous issue date: 2017-06-26 / The present dissertation approaches the emotion in the subjectivity of the medicine student facing the death of the patient, based on the qualitative epistemology. The general objective of the search was to understand how medicine students experience patient’s death, trying to identify their emotions in this context and to analyze their relationships with their subjectivities in their development processes. The study was carried out at an Academic Institution in Anápolis. Three medical students, aged 24, 33 and 34, all male, chosen by lottery made in the classroom participated in the study. After they signed a Free and Informed Consent Term, these students participated in the information construction about the death of the patient, in three different empirical moments with the following resources (as Instruments): open dialogue, discussion of a clinical case and discussion of a video. The results showed that each student experiences the patient’s death in a unique way, with singular emotions, an element of their subjectivities, although in their formation process they are extensively exposed to the meaning of death in the biomedical model as an adversity that they always need to fight against. Through this result, it was concluded that medical students need to discuss in their formation process about their subjectivities and how they can face the death of the patient, a fact that most of the times is faced as failure, a mistake, even if they know that mistake is part of all humans’ life. This can help them to place themselves ethically and emotionally to exercise their profession. / A presente dissertação aborda a emoção na subjetividade do acadêmico de medicina frente a morte do paciente, tendo como base a epistemologia qualitativa. O objetivo geral da pesquisa foi compreender como os acadêmicos de medicina vivenciam a morte do paciente, procurando identificar as suas emoções nesse contexto e analisar suas relações com as suas subjetividades nos seus processos de desenvolvimento. O estudo foi realizado em uma Instituição de Ensino Superior de Anápolis. Participaram do estudo três acadêmicos, com idades de 24, 33 e 34 anos, todos do sexo masculino, selecionados por meio de sorteio em sala de aula. Após a assinatura do Termo de Consentimento livre e esclarecido, esses acadêmicos participaram da construção das informações sobre a morte do paciente, em três momentos empíricos diferentes com os seguintes recursos (como Instrumentos): diálogo aberto, discussão de um caso clínico e a discussão de um vídeo. Os resultados apontam que cada acadêmico vivencia a experiência de morte do paciente de forma única, com emoções singulares, um elemento de suas subjetividades, embora no processo de formação sejam perpassados pela significação da morte no modelo biomédico, de que é preciso lutar contra ela sempre. Mediante esse resultado, concluiu-se que os acadêmicos necessitam discutir no processo de formação sobre as suas subjetividades e como a partir delas eles podem enfrentar a morte do paciente, fato que na maioria das vezes é vivenciado como um fracasso, um erro, mesmo que eles saibam que o erro faz parte da vida de todo ser humano. Isso poderá ajudá-los a melhor se posicionarem ética e emocionalmente para exercerem a profissão.

INTRODUÇÃO: Existe uma atenção crescente pela introdução de disciplinas de ciências humanas e de artes na educação médica. A música é instrumento pouco utilizado no ensino médico. Ela possui características únicas que a tornam um excelente recurso educacional, pela possibilidade de exprimir emoções. Em poucos minutos, temas de interesse no aprendizado médico, como a perda, a compaixão, a tristeza e a solidariedade, podem ser identificados e utilizados em processos pedagógicos. A música como outras manifestações artísticas permite lidar com o universo afetivo do aluno. Promover a atitude reflexiva dentro de uma disciplina acadêmica requer criar espaço formal para fazê-lo. OBJETIVO: Apreender o impacto da música como recurso pedagógico na experiência do estudante de medicina. METODOLOGIA: A pesquisa segue uma abordagem de natureza qualitativa. Utilizaram-se músicas pré-definidas pelo autor durante as aulas do módulo em Medicina de Família no internato médico de Faculdade de Medicina do Estado de São Paulo. Participaram doze estudantes que cursaram essa disciplina. As entrevistas foram gravadas, transcritas e, em seguida, xii interpretadas segundo a perspectiva hermenêutica. RESULTADOS: O processo de compreensão da experiência dos estudantes possibilitou o desvelamento de um fenômeno que engloba o seu mundo interno enquanto se ocupa com sua formação médica. A música que toca do lado de fora ressoa na história e nas emoções do estudante. O aluno percebe que o ritmo imposto pelo curso médico não lhe permite pensar, refletir, seja em sua própria vida, seja em sua formação. A experiência com a música permite ao estudante ouvir seus próprios sentimentos e compartilhá-los com o professor e com seus colegas. Ele se surpreende com lembranças e sentimentos que vêm à tona e que desconhecia ou dos quais não se lembrava. Esses sentimentos estão apresentados em temas que organizam a experiência afetiva do estudante, mobilizada pela música. Surgiram assim diversas categorias temáticas, como a busca de si, família, morte, dúvidas vocacionais e relacionamento com colegas, professores e pacientes CONCLUSÃO: Os resultados encontrados na experiência com a música se apresentam em amplo espectro, oferecendo inúmeras perspectivas de desdobramento no âmbito da educação médica, conforme observamos nos temas surgidos. Como a experiência básica que se tem do mundo é emocional, a música essa forma de conhecimento humano de tonalidade afetiva adquire também força educacional, pois o processo de ensinar não se limita à transmissão de conteúdos; mais que isso, implica, por parte do docente, processos de desenvolvimento de sentidos e de significados para permitir que o xiii estudante reflita e transforme a prática cotidiana, sobretudo na medicina, onde o relacionamento interpessoal é a base para a plena efetividade da futura ação profissional / INTRODUCTION: There is a growing focus by the introduction of courses in humanities and arts in medical education. Music is not widely used tool in medical education. It has unique features that make it an excellent educational resource for the possibility to express emotions. Within minutes, topics of interest in learning medicine as loss, compassion, sorrow, solidarity can be identified and used in pedagogical processes. Music like other forms of art can deal with the emotional universe of the student. Promoting reflective attitude within an academic discipline requires creating space to make it formal. OBJECTIVE: To grasp the impact of music as an educational resource on the experience of medical students. METHODOLOGY: The research follows a qualitative approach. We played songs predefined by the author during the classes in family medicine module at the boarding school of medicine in the state of Sao Paulo. Twelve students who attended this course agreed to participate. The interviews were taped, transcribed and then interpreted according to the hermeneutic perspective. RESULTS: The process of understanding the experience of students allowed for the xv unveiling of a phenomenon that encompasses your inner world as he attends to his medical training. The music played on the outside resonates in the story and emotions of the student. The student realizes that the pace imposed by the medical school does not allow to think about, reflect, whether on his own life, whether in his formation. The music experience allows students to hear their feelings and share them with the professor and peers. He is surprised by memories and feelings that surface and was unaware or they could not remember. These feelings are presented in themes that organize the affective experience of the student, mobilized by the music. Several themes emerged as well as the search for self, family, death, vocational doubts, relationships with peers, professors and patients CONCLUSION: The findings of the experience of the music spectrum come in, offering numerous prospects for development in the context medical education, as noted in the themes that emerged. As the basic experience we have of the world is emotional, the music, this form of human knowledge of affective tone also becomes educational force, because the process of teaching is not limited to transmission of content but, more importantly, implies that the teacher in development processes of meaning and significance to enable the learner, reflect and transform the everyday practice, especially in medicine where the interpersonal relationship is the basis for the full realization of future professional action

No description available.

Introduction: Burnout is an occupational condition characterized by emotional exhaustion, depersonalization, and a low sense of personal accomplishment. While medical students begin schooling with mental health profiles similar to or better than peers who pursue other careers, there is a downward trajectory throughout school suggesting this phenomenon often originates in medical school. For physicians and residents, burnout has been linked to poor outcomes such as patient safety, might contribute to suicidal ideation and substance abuse, and may undermine professional development. Furthermore, there is a lack of surveillance of the prevalence of medical student burnout in a small-sized school setting. Methods: The Maslach Burnout Inventory (MBI), a 22-question survey, is largely accepted as the gold standard for assessment; however, we utilized the 7-question, Well-Being Index (WBI), which has been shown equal efficacy as the full MBI. Eligible participants were currently enrolled in their respective class at the East Tennessee State University Quillen College of Medicine. Each year, a participant was given a WBI survey during the winter season (overall response rate 83%, n = 239). Results: Overall the self-reported burnout rate over the two-year study period was 65.2% and was significantly higher in those reporting as female (71%). There was also variation tracking the class from one year to the next. The second year at this institution showed the highest reported amount of burnout (75%, n=145) while the lowest amount of burnout reported was during the fourth year at 47%. Conclusions: Burnout experienced at this institution was reportedly higher than national average. There are limitations to this study as the periods in which medical students were asked to answer the survey were consistently at the same time in the calendar year, but the host institution’s curriculum had been changed so that it might not match up accordingly. Furthermore, class sizes changed from year to year and might skew the data. This information suggests that burnout prevalence is higher at Quillen College of Medicine and intervention strategies to address burnout should be pursued.

Depression är vanligt förekommande världen över och läkarstudenter är en utsatt grupp. Under läkarprogrammet ökar dessutom den psykiska ohälsan bland studenterna. Förmågan till psykologisk flexibilitet, innefattande defusion, acceptans, jag-som-kontext, flexibel uppmärksamhet i nuet, värden och ändamålsenligt handlande, har visat sig ha samband med ohälsa. Training for Awareness, Resilience and Action (TARA) har skapats i USA som metod för att i grupp behandla depression hos tonåringar. Under 2018 erbjöds TARA till en grupp läkarstudenter i Umeå och denna kvalitativa studie innefattade semistrukturerade intervjuer två år efter avslutad behandling. Deltagarna var fem av dessa studenter och intervjuerna fokuserade på deras upplevelser av TARA samt vilka metoder de fortsatt att använda. Åldern på deltagarna var 21-32 år vid intervjutillfället. En tematisk analys användes för att analysera materialet från intervjuerna. Resultatet visade att deltagarna upplevde att de fick flera olika verktyg att använda sig av för att hantera sin psykiska ohälsa. Främst var andningsövningar och att uppmärksamma det som hände inom dem som beskrevs som det viktigaste. Deltagarnas beskrivningar av deras erfarenheter visar att de övat upp sin förmåga till defusion, acceptans, flexibel uppmärksamhet i nuet, värden och ändamålsenligt handlande under TARA. Beskrivningar av jag-som-kontext gick inte att hitta i materialet. Studiens utformning, kvalitativa intervjuer, och urvalet av deltagare har minskat möjligheten till generalisering. Dock kan resultatet förstås som att TARA kan hjälpa till att öka upplevelsen av psykologisk flexibilitet, vilket i förlängningen kan minska symtomen på depression. / Depression is common worldwide and medical students are a vulnerable group and during the medical education mental illness increases. The ability for psychological flexibility, including diffusion, acceptance, Self-as-context, flexible contact with the present, values ​​and appropriate action, has been shown to be associated with ill health. Training for Awareness, Resilience and Action (TARA) has been created in the United States as a method of treating depression in group in adolescents. In 2018, TARA was offered to a group of medical students in Umeå and this qualitative study included semi-structured interviews with five of these students about their experiences of TARA and what methods they are using. The interviews were conducted two years after their participation in TARA. The participants attended the second and forth semester of their education when TARA occurred. The age of the participants was 21-32 years at the time of the interview. A thematic analysis was used to analyze the material from the interviews. The results showed that the participants felt that they were given several different tools to use to manage their mental illness. Mainly breathing exercises and paying attention to what was happening within them was described as the most important. The participants' descriptions of their experiences show that they practiced their ability for defusion, acceptance, flexible contact with the present, values ​​and appropriate action during TARA. Descriptions of Self-as-context couldn’t be found in the material. The design of the study, qualitative interviews, and the selection of participants have reduced the possibility of generalization. However, the result can be understood as that TARA can help to increase the experience of psychological flexibility, which in the long run can reduce the symptoms of depression.